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Why would a low carb diet drive up my fasting glucose and A1C?
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Why would a low carb diet drive up my fasting glucose and A1C?

I'm a 60-year old woman, weigh 105 lbs, exercise regularly.  I take meds for hypertension and cholesterol and I also take synthroid.  About 6 months ago I started a low carb diet for my overall health because heart disease is in my family.  I cut out processed foods, bread, white potatoes, pasta, crackers, candy, cereal, desserts.  My diet consists of salads with reduced fat dressings, salmon, chicken, tuna, occasional steak, green vegetables, occasional sweet potato, nuts, cottage cheese, greek yogurt and Atkins bars.  I recently had a blood test and my fasting blood sugar went from 87 to 96, and my A1C rose from 5.8 to 5.9.  I was shocked because my diet has not included simple carbs for the past 6 months.  Can you give me some insight as to what may be driving up my fasting gluclose and A1C if I'm not eating high carb foods?  I do not cheat on my diet and I exercise 3-4 days per week. I would be happy to adjust my diet again, but I'm at a loss as to what can be causing this.  Thank you.
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141598_tn?1355675363
Your fasting levels are within normal range but your A1c says otherwise; 5.8%=120 mg/dl, and 5.9%=123 mg/dl. Both are prediabetes and tip-toeing closely to diabetes land.

What "meds for hypertension and cholesterol" are you taking? We can search to see if possible drug interaction/s are taking place. Drug interactions may/can elevate glucose levels.

It's important to read nutrition labels carefully. Many salad dressings contain large amounts of sugar, most are listed under carbohydrates in grams. Every 7 grams equals one heaping tablespoon of sugar. Although Greek yogurt is low in carbs, carb sugars can average 5 grams per serving [2/3 cup]. However, if you consume yogurt as part of your pre-workout regimen you may be able to burn of the carbs and sugar as energy. The only way to know is by testing after your post exercise rest down period. You do have a home glucose test meter, right?

This is an excellent web site to look up nutritional data on all foods you consume. Search Atkins bars by name followed by the word 'nutrition'. Some have zero sugars others up to 5 grams.
http://nutritiondata.self.com/

Good luck -
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Avatar_f_tn
Thanks, WaveRider.  I just ordered a glucose meter on the Internet and will start testing to see what's driving up my glucose.  You're right about the salad dressings.....I checked them out and one of my favorites which is Lite Raspberry Vinagrette has 6 grams of sugar per serving.  I was wary about the yogurts which have 15 grams of sugar per serving.  The Atkins bars all say 'low glycemic index' so I never questioned those.  I'm just surprised that after giving up a diet packed with simple carbs and processed foods for a diet that I perceived to be almost carb free, that my sugar would go up.  Another explanation could be that it is in my family....my brother has had diabetes for the past 20 years, my maternal grandmother had it, and my fraternal twin has an A1c that hovers around 6.1.  Thanks again...I'm looking forward to learning more when I receive the meter.
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Avatar_f_tn
I forgot to tell you my blood pressure meds.  I've been taking Lotrel 5/20 for years (Amlodipine 5/Benazepril 20) and within the last year added 25 mg Spironolactone (potassium sparing diuretic).  Also around the same time I started the "low carb" diet, I started taking 500 mg of SloNiacin, which I know can cause an increase in glucose.  However, I am taking a relatively low dose.  If this is being caused by my meds, there's really nothing I can do, correct?  I'm very restricted as to what meds I can take due to allergies and side effects.
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141598_tn?1355675363
You're welcome Ruthiejb. Also, watch out for hidden sugars like dextrose [a carb sugar], sucrose, fructose [fruit sugar] and HFCS [made from corn starch]. Eat fruits with other foods to slow the absorption of fructose. Understand which fruits are low in fructose and which ones that are way high on the do not eat list.

I don't get the SloNiacin. Niacin is a B3 and is known to elevate blood sugars. You can control cholesterol through proper nutrition. Use Google search on 'foods that may raise cholesterol' then avoid them, like ground turkey.

With regular exercise it is important to adjust your carb intake accordingly. It's a catch-22; carbs raise blood sugars but at the same time we need carbs [glycogen from the liver] for energy. This is why testing is very important to understand how much carbs your body can take. Test times are:

· preprandial - b4 a meal to get a baseline measurement
· postprandial - 2-3 hours after eating to see how the foods you ate affected your levels. Compare against preprandial
· B4 exercise - like preprandial gives you a baseline measurement
· 30-40 minutes after exercise [rest down or cool down period] - presents a good insight on how much blood sugar you burnt off.

Lotrel - may raise blood sugars
Spironolactone - may raise blood sugars
If these elevated your blood sugars you would have seen that a long time ago. Instead, concentrate on proper nutrition and continue with the exercising. Good luck -

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231441_tn?1333896366
Hi,

as seen above there may be hidden carbs in your diet.  However, I would be more inclined to think that you may be prone to developing diabetes anyway and it is just slowly progressing.

For your diet, it seems you are trying to eat low carb and low fat.  You may feel better and more satisfied if you add some more healthy fats to your diet.  Heathy fats include olive oil (you can make your own salad dressing this way), avocado, nuts, fats from meat (generally choose leaner cuts of meat, but eat the fat that then comes with the meat), cheese, full fat (unsweetened) dairy, fish.

You could ask your doctor about starting metformin.  It is often a first line drug in early diabetes and may help stop it progressing further.

Best wishes

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Avatar_f_tn
I do appreciate your advice.  WaveRider, thank you for the testing times....I know nothing about it and will have to learn.  Unfortunately, high cholesterol also runs in my family and I need the medicines.  My doctor is unconcerned; we communicated via e-mail and when I expressed my concern over the 5.9 A1c, his response was, "it's an acceptable A1c, just watch for trends."  Well, it's trending up!  I'm just very frustrated because I thought I was really doing everything right as far as diet and exercise.  I get a lot of grief from (nosy) friends about being underweight; I did lose weight when I changed my diet; I wasn't trying to and I didn't really have to.  Sally, I appreciate the food advice and I'm thinkiing you're right that I'm slowly moving towards diabetes.  My husband takes Metformin (not for diabetes but for metabolic syndrome), and depending on my next blood test in September, I will talk to my doctor about taking it too.  By the way, I looked at the ingredients in my salad dressings and I found that most contain "maltodextrin" which I read was worse than sugar for driving up blood sugars.  I'm glad I'm learning.  Thanks again and best wishes.
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141598_tn?1355675363
Maltodextrine in very small amounts is OK, Mostly used in foods as a binding agent. However, it still is a modified corn starch sweetener. If its listed closer/higher to the first listing on the nutrition label there is more of it in that particular food. Put it back on the shelf.
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Avatar_f_tn
I was at the grocery store yesterday and came upon salad dressings in the refrigerated section of the produce department made by a company called Walden Farms.  It says on the label, "no calories, no fat, no carbs, no gluten, no sugars of any kind!"  And they had all different flavors.  Hard to beieve, eh?  I looked at the ingredients and didn't see any of those bad ingredients I read about , so I bought the buttermilk ranch and the balsamic vinaigrette.  I tried the ranch yesterday and it wasn't too tasty.  I'll try the balsamic today.  They have a website if you'd like to check it out:
http://www.waldenfarms.com/
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141598_tn?1355675363
Thanks for posting your find, Ruthiejb. I checked the Walden site. Salad dressings use Splenda [sucralose] as the sweetening agent, a non-digestible sugar derivative that doesn't raise glucose levels. My only concern is the amount of sodium per serving [2 Tbsp], quite high IMO. By adding EVOO perhaps you can double the serving size w/o adding sodium. Another thought is eating salad with Walden's after workout to replenish lost sodium [an electrolyte] from sweat.
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Avatar_f_tn
I should be receiving my glucose meter tomorrow and will start testing to see what's going on with my BG.  In the meantime, I've read several articles that have said that the A1c is not necessarily accurate in non-diabetic people because, according to one doctor, their RBC's live longer so the glucose has more time to accumulate.  Although I'm not sure I get that because the A1c is an average, isn't it?  Anyway, this one doctor has said that he sees it in his practice all the time, i.e., patients whose fasting glucose is normal and who also test normal with the glucose tolerance test, however, their A1c is over 5.7.  Also, I read that people whose blood is low in iron can also test falsely high on their A1c.  I checked out my blood results and my iron level is barely above the low cutoff for normal.  So, I wonder if that has anything to do with my higher A1c.  Oh well, I'll know soon enough I guess.
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141598_tn?1355675363
"...the A1c is not necessarily accurate in non-diabetic people because, according to one doctor, their RBC's live longer so the glucose has more time to accumulate."

Keep in mind medicine is a science and there will always be two sides to the coin. It is true not everyone are the same and RBC's may live longer in some and perhaps even shorter in others. Whether this applies to non-diabetics vs diabetics I would say maybe in some but not everyone. If it was true it would be written in stone, per se. IMO this debate can be endless. Somewhere along the line a stance has to be made to help make a decision on the patients behalf. I try to follow the AACE [American Association of Clinical Endocrinologist] guidelines. There the doctors not I.

The A1c does provide a good insight by capturing the excess glucose on "new" RBC's. Convert your A1c results into estimated Average Daily Glucose [eAG] with this formula

28.7 x A1c - 46.7 = eAG in mg/dl
[note: mmol/l uses another formula]

But, nothing beats daily testing especially postprandial.
HTH
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Avatar_f_tn
Again, thank you Wave Rider.  I was wrong about the glucose meter....it won't arrive until July 11th so I'll start testing then.  We shall see.
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141598_tn?1355675363
Got a Wal-Mart near you? Consumer Reports gave their 3 meters high rankings. They run around $10 bucks. I Keep a backup meter handy to not only use if I doubt the 1st meters readings, but also in case I misplace it while traveling [happened to me once, sigh] I know I have one at home.
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Avatar_f_tn
Good advice, thanks again, WaveRider.  I purchased a Walgreens TruResult which also received good reviews.  I should've bought it from my local Walgreens instead of ordering it from drugstore.com because it was $5 cheaper.  And I would've had it days ago.  Live and learn.
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141598_tn?1355675363
You're welcome.
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Avatar_f_tn
Just FYI, I've been testing for 2 days and so far so good.  The highest BG registered was 121 which was an hour after eating dinner (which included a sweet potato) and an hour after that it was 97.  I tested 2 hours after dinner tonight which was low carb (no sweet potato), and it was 83.  (I used the control solution before using the meter and it was in the correct range so I assume it's accurate).  I know it's only been 2 days but perhaps I'm one of those people with an A1c that doesn't reflect my true BG (which I'm reading more and more about).
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141598_tn?1355675363
"perhaps I'm one of those people with an A1c that doesn't reflect my true BG (which I'm reading more and more about)."

My HMO hospital lab has their equipment checked every 30 days. If your doctor is using in-office equipment you might ask when it's checked. If he/she is sending it to an outside lab for analysis the possibility of error exist [heat, too long of b4 testing, etc].

Better yet, did you know Walgreens sells Bayer home A1c test kits? Suggest you keep up with your lifestyle and test yourself in 3 months. Good luck -
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Avatar_f_tn
Thanks again, WaveRider, I do appreciate your advice.  Costco also sells the Bayer A1c but I always hesitated to buy it because I've read it isn't that accurate.  I will admit, though, that I did read about it a while back so maybe it has improved.  I will definitely look into it since I've taken the first big step of getting a meter.
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